| NPI | 1326209586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 5695) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: AZ D7519) |
| 1223G0001X Dentist General Practice (Licence: CA 58217) | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2016-04-26 |